THE ROLE OF NUTRACEUTICALS IN THE MANAGEMENT OF DYSLIPIDEMIA AND THEIR EFFECTS ON LIPID METABOLISM: A SYSTEMATIC REVIEW

Klaudia Jurga; Maurycy Jabłoński; Laura Kobaka; Jakub Chołast; Wiktoria Łuniewska; Jakub Kacer; Julia Kacer; Jakub Niepokój; Marta Modrzyk; Dawid Kwiatkowski

doi:10.31435/ijitss.3(51).2026.6219

Authors

Klaudia Jurga Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0009-0004-3676-8166
Maurycy Jabłoński Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0009-0006-6793-6534
Laura Kobaka Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0009-0007-1010-3467
Jakub Chołast Lower Silesian Oncology Center, pl. Ludwika Hirszfelda 12, 53-413 Wroclaw, Poland https://orcid.org/0009-0006-7180-2029
Wiktoria Łuniewska Wroclaw Medical University, Wroclaw, Lower Silesia, Poland https://orcid.org/0009-0009-5398-422X
Jakub Kacer Lower Silesian Oncology Center, pl. Ludwika Hirszfelda 12, 53-413 Wroclaw, Poland https://orcid.org/0009-0005-8573-0815
Julia Kacer Wroclaw Medical University, Wroclaw, Lower Silesia, Poland https://orcid.org/0009-0005-1709-3236
Jakub Niepokój Wroclaw Medical University, Wroclaw, Lower Silesia, Poland https://orcid.org/0009-0003-5273-4532
Marta Modrzyk Institute of Medical Sciences, Opole, Poland https://orcid.org/0009-0003-9590-5602
Dawid Kwiatkowski Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0009-0006-3296-5538

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6219

Keywords:

Dyslipidemia, Nutraceutics, Lipid Metabolism, CVD, Cholesterol

Abstract

Dyslipidemia is one of the top modifiable causes of ASCVD‚ which is still the leading cause of death worldwide․ Statins are first line treatment‚ but potentially reversible obstacles to effective treatment include patient discontinuation‚ statin intolerance‚ concern about statin-related adverse effects‚ and residual cardiometabolic risk in patients who are apparently well treated with statins․ Over the years‚ nutraceuticals have also been of interest as adjunctive agents affecting lipids‚ but also glucose metabolism‚ inflammation‚ intestinal absorption of cholesterol‚ and vascular biology․ Today‚ their role is not to replace established pharmacological therapy but to complement it in selected patients with low or moderate cardiovascular risk‚ or patients who are statin-intolerant or statin-ineligible (Penson & Banach‚ 2020; Cicero et al․‚ 2017; Banach et al․‚ 2018)․ Here we review the clinical and mechanistic evidence for selected nutraceuticals used for dyslipidemia and other components of the metabolic syndrome․ These include red yeast rice‚ soluble

fiber‚ omega-3 fatty acids‚ phytosterols‚ berberine‚ bergamot polyphenols‚ curcumin‚ and other common functional foods․ We also describe issues related to the quality of preparation‚ inter-individual variability in pharmacokinetics and -dynamics‚ bioavailability‚ untoward side effects‚ and the relationship of surrogate marker changes to hard cardiovascular outcomes․ An additional aspect sometimes discussed includes the therapeutic dilemma of statin intolerance and the nocebo effect in the clinical setting (Banach et al‚ 2015; Banach et al․‚ 2018; Mach et al․‚ 2020)․ In general‚ there is support for the use of several nutraceuticals in the primary prevention setting‚ in partially statin intolerant patients and on top of standard therapies․ Even though the effect sizes are not dramatic‚ they can be clinically meaningful in defined patient populations․ On the other hand‚ this field is still marred by a lack of product standardization‚ poor quality of studies‚ and a lack of large outcome-driven clinical trials․ Nutraceuticals should be seen as one component of a thorough prevention strategy and not a replacement for evidence-based pharmacotherapy․ Nutraceuticals used to lower dyslipidemia are red yeast rice‚ soluble fiber‚ omega-3 fatty acids‚ phytosterols‚ and berberine․

Objective: To evaluate the role of nutraceuticals in the management of dyslipidemia and to assess their effects on lipid metabolism based on currently available clinical evidence.

Materials and methods: A thorough review of published peer-reviewed studies on the pharmacological role of nutraceuticals in the treatment of dyslipidemia and in the modulation of lipid metabolism was conducted‚ which included meta-analyzes‚ systematic reviews‚ randomized controlled trials‚ placebo-controlled clinical studies‚ expert position papers and international guidelines to evaluate their efficacy‚ safety‚ and application in dyslipidemic patients․

We focused on the nutraceuticals with lipid-lowering effects‚ specifically omega-3 fatty acids‚ red yeast rice‚ plant sterols and stanols‚ soluble fiber‚ berberine‚ bergamot‚ cocoa

products‚ curcumin‚ coenzyme Q10‚ and nutraceutical combinations․ The inclusion criteria were studies that addressed the management of dyslipidemia with lipid-specific endpoints‚ of which total cholesterol‚ low-density lipoprotein cholesterol (LDL-C)‚ high-density lipoprotein cholesterol (HDL-C)‚ and triglycerides were the most relevant ones․ Evidence regarding the putative mechanisms of action of nutraceuticals on lipid metabolism‚ as well as the effect of nutraceuticals as an add-on or alternative lipid-lowering therapy‚ was particularly highlighted․ Results were narratively synthesized based on the type of nutraceutical and the reported effect on lipid profile and cardiometabolic risk outcomes.

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